Customer Reimbursement Coordinator

Overview: The Customer Reimbursement Coordinator is responsible for providing direct assistance to customers with their reimbursement inquiries and claims. This role involves verifying insurance benefits, assisting with claims processing, initiating prior authorizations with payers on behalf of providers, answering customer queries, and ensuring compliance with reimbursement policies and regulations. The ideal candidate will have strong communication skills, a detail-oriented mindset, and experience in customer service or healthcare reimbursement.
Responsibilities:

Respond to customer inquiries regarding reimbursement policies, claims status, and procedures via phone, email, and other communication channels

Provide clear and accurate information to customers about the reimbursement process

Provide appeal and denial support for negative outcome authorization requests

Assist customers in completing and submitting reimbursement claims

Review and verify benefits in accordance with company policies and regulatory requirements

Verify the accuracy and completeness of claim documentation

Ensure timely and efficient assistance with the processing of claims to meet customer needs and company standards

Maintain detailed and organized records of customer interactions and claims processing

Ensure all documentation is accurate, up-to-date, and compliant with relevant regulations

Prepare and submit reports on reimbursement activities and trends as required

Adhere to all relevant regulations, policies, and procedures related to reimbursement

Conduct regular quality checks to ensure high standards of service and compliance

Stay informed about changes in reimbursement policies and procedures and update customers and internal teams accordingly

Work closely with other departments to resolve complex reimbursement issues and improve processes

Provide support and assistance to team members as needed

Participate in training and development activities to enhance knowledge and skills

Skills/Qualifications:

Associate’s degree in business, healthcare administration, or a related field or equivalent work experience is required, a bachelor’s degree is preferred

Minimum of 4 years of experience in customer service, healthcare reimbursement, or a related field

Strong understanding of reimbursement processes and regulations

Excellent communication and interpersonal skills

High level of attention to detail and accuracy

Proficiency in using customer support software and office applications

Experience with reimbursement management systems and software

Knowledge of healthcare insurance and billing processes

Certification in healthcare reimbursement or a related field

* Please note, we do not provide sponsorship at this time.
Originally posted on Himalayas